1 / 22

ECZEMA

ECZEMA. DR SIVANIE VIVEHANANTHA DERMATOLOGY STR. AIMS. Brief overview of eczema Enable early recognition & effective management. ECZEMA. CLASSIFICATION OF ECZEMA. ENDOGENOUS Atopic Seborrheic Discoid Pompholyx / dyshidrotic Varicose / venous / stasis / gravitational. EXOGENOUS

kane-ramos
Télécharger la présentation

ECZEMA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. ECZEMA DR SIVANIE VIVEHANANTHA DERMATOLOGY STR

  2. AIMS • Brief overview of eczema • Enable early recognition & effective management

  3. ECZEMA

  4. CLASSIFICATION OF ECZEMA ENDOGENOUS • Atopic • Seborrheic • Discoid • Pompholyx / dyshidrotic • Varicose / venous / stasis / gravitational EXOGENOUS • Allergic contact • Irritant contact • Photosensitive / photoaggravated

  5. PATCH TEST

  6. MANAGEMENT OF EXOGENOUS EZCEMA • Avoidance of offending agent • Topical steroids +/- prednisolone • Patch testing for allergic contact dermatitis or photo-patch testing for photo-allergic dermatitis • Soap substitutes and emollients

  7. HISTORY • Age of onset? • H/O childhood eczema? • Any evidence of worsening eczema with diet? If so, which type of food? • Areas affected? • Worsening / improving / static disease? • Eczema free days? • Pruritus? If so, does it keep the patient up at night? • Antibiotics? Hospitalisation for infective flare ups? • H/O eczema herpeticum? • H/O erythroderma?

  8. PMH: Atopy? • FH: - Atopy? - Ask specifically if any siblings. If has siblings, atopy? • DH: - What meds? - Previous treatments? Helpful / unhelpful? - Current treatment? Helpful / unhelpful? - Always ask about: • Frequency of application and quantities used! • SS , shampoo, emollient, topical steroid, steroid sparing agent, scalp applications, suits, antihistamines • Days off school / work?

  9. MANAGEMENT • Bath additives (antibacterial?) • Soap substitute (antibacterial?) and shampoo • Emollient • Topical steroid (combination with topical antibiotic?) • Steroid sparing agents eg. topical tacrolimus • Scalp application • Potassium permanganate soaks

  10. Suits • Bandaging eg. viscopaste, tubigrip • Antihistamines (driving advice!) • Allergen avoidance • Dietitician involvement? • Occupational health involvement • IgE levels? (inteprete with caution!) • Systemic treatment eg. prednisolone, ciclosporin etc

  11. Tailor treatment to each INDIVIDUAL patient’s needs and adapt management plan to increase compliance! • Remember Afrocaribbean / Black people only wash their hair once a week and may be reluctant to use certain topical treatment if hair relaxed. Ask patient if they are willing to change hairstyle. • Nurse involvement in skin care regimen • REMEMBER: 1 FTU = 0.5 grams = Covers surface area equivalent to 2 palms Ensure patient is aware of this and prescribe adequate amounts of topical treatment!

  12. ERYTHRODERMA • > 90% involvement of inflammatory skin disease • Causes: - Eczema - Psoriasis - CTCL (Sezary syndrome) - Drugs - Lymphoma / leukaemia - GvHD - HIV - Idiopathic

  13. Consequences: - Heat loss - Fluid loss (Hypovolaemia and renal failure) - Electrolyte imbalance - High output cardiac failure - Hypoalbunaemia - Hyperuricaemia - Death! • Mx (Symptomatic): - Rx underlying condition / remove offending drug - Temperature control - IV fluids - Dietician input +/- ITU admission

  14. SUMMARY • Brief overview of eczema • Early recognition and effective management • Early involvement of Dermatologist when eczema is poorly controlled +/- erythrodermic or if patch test is required

  15. THANK YOU

More Related